Application of HFOV and PLV in ALI/ARDS_Chinese Journal of Respiratory and Critical Care Medicine

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LI Li , HE Yuanbing

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Keywords：

高頻振蕩通氣; 部分液體通氣; ALI/ARDS

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急性肺損傷( ALI) 及急性呼吸窘迫綜合征( ARDS) 是各種肺內外致病因素導致的急性呼吸衰竭, 以進行性呼吸困難和頑固性低氧血癥為特征, 常繼發于休克、創傷、嚴重感染以
及大面積燒傷等疾病。病理以雙肺彌漫性的滲出為特點。病情進展迅速, 預后極差, 具有很高死亡率。治療時需要糾正缺氧, 以保證組織氧供。傳統的常規機械通氣( CMV) 在
改善氧合、呼吸力學參數以及肺內炎癥反應的同時, 導致肺損傷, 即呼吸機相關性肺損傷( VALI) 。近年認為, 采用高頻振蕩通氣( HFOV) 代替CMV 能明顯避免產生VALI, 并能改
善ALI/ARDS的呼吸系統順應性和氧合作用, 減輕肺內炎癥反應和VALI, 利于急性損傷肺內塌陷和閉塞的小氣道和肺泡重新開放。并且有人提出HFOV 與部分液體通氣( PLV)
聯用( HFOV-PLV) 可進一步改善氣體交換, 抑制肺組織的炎性反應, 減少肺損傷及氟碳化合物( PFCs) 用量, 穩定全身血液循環, 減少中樞神經系統( CNS) 并發癥[ 1] 。

Citation： LI Li,HE Yuanbing,ZENG Yun. Application of HFOV and PLV in ALI/ARDS. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(1): 99-101. doi: Copy

1.	周濤,陳賢楠.高頻振蕩通氣與其它呼吸支持方式聯合應用的研究進展.中國實用兒科雜志,2000,15:181.
2.	Chan KP,Stewart TE,Mehta S.High-frequency oscillatory ventilation for adult patients with ARDS.Chest,2007,131:1907-1916.
3.	Ferguson ND,Stewart TE.New therapies for adults with acute lung injury.High-frequency oscillatory ventilation.Crit Care Clin,2002,18:91-106.
4.	Mehta S,Lapinsky SE,Hallett DC,et al.Prospective trial of high-frequency oscillation in adults with acute respiratory distress syndrome.Crit Care Med,2001,29:1360-1369.
5.	Andersen FA,Guttormsen AB,Flaatten HK.High frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome--a retrospective study.Acta Anaesthesiol Scand,2002,46:1082-8.
6.	Chan KP,Stewart TE.Clinical use of high-frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome.Crit Care Med.2005 Mar,33(3 Suppl):S170-174.
7.	Derdak S,Mehta S,Stewart TE,Smith T,et al.High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: a randomized,controlled trial.Am J Respir Crit Care Med,2002,166:801-808.
8.	Bartz RR.What is the role of high-frequency ventilation in adult respiratory distress syndrome? Respir Care Clin N Am,2004,10:329-339.
9.	Rotta AT,Gunnarsson B,Fuhrman BP,et al.Comparison of lung protective ventilation strategies in a rabbit model of acute lung injury.Crit Care Med,2001,29:2176-2184.
10.	Rüdiger M,Wissel H,Ochs M,et al.Perfluorocarbons are taken up by isolated type II pneumocytes and influence its lipid synthesis and secretion.Crit Care Med,2003,31:1190-1196.
11.	Migliori C,Bottino R,Angeli A,Cattarelli D,Chirico G.Highfrequency Partial Liquid Ventilation in Two Infants.Journal of Peri2 Natology.J Perinatol,2004,24:118-120.
12.	Rotta AT,Viana ME,Wiryawan B,et al.Combining lung-protective strategies in experimental acute lung injury: The impact of high-frequency partial liquid ventilation.Pediatr Crit Care Med,2006,7:562-570.
13.	Doctor A,Price B,Bhargava N,et al.High-frequency oscillatory ventilation of the perfluorocarbon-filled lung: dose-response relationships in an animal model of acute lung injury.Crit Care Med,2001,29:847-854.
14.	Göthberg S,Parker TA,Abman SH，et al.High-frequency oscillatory ventilation and partial liquid ventilation after acute lung injury in premature lambs with respiratory distress syndrome.Crit Care Med,2000,28:2450-2456.
15.	Roemer WM,Gentzsch S,Andel H,et al.Pressure increase due to hydrostatic pressure of perfluorocarbon.Am J Respir Crit Care Med,2006,173:1046-1047.

1. 周濤,陳賢楠.高頻振蕩通氣與其它呼吸支持方式聯合應用的研究進展.中國實用兒科雜志,2000,15:181.
2. Chan KP,Stewart TE,Mehta S.High-frequency oscillatory ventilation for adult patients with ARDS.Chest,2007,131:1907-1916.
3. Ferguson ND,Stewart TE.New therapies for adults with acute lung injury.High-frequency oscillatory ventilation.Crit Care Clin,2002,18:91-106.
4. Mehta S,Lapinsky SE,Hallett DC,et al.Prospective trial of high-frequency oscillation in adults with acute respiratory distress syndrome.Crit Care Med,2001,29:1360-1369.
5. Andersen FA,Guttormsen AB,Flaatten HK.High frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome--a retrospective study.Acta Anaesthesiol Scand,2002,46:1082-8.
6. Chan KP,Stewart TE.Clinical use of high-frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome.Crit Care Med.2005 Mar,33(3 Suppl):S170-174.
7. Derdak S,Mehta S,Stewart TE,Smith T,et al.High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: a randomized,controlled trial.Am J Respir Crit Care Med,2002,166:801-808.
8. Bartz RR.What is the role of high-frequency ventilation in adult respiratory distress syndrome? Respir Care Clin N Am,2004,10:329-339.
9. Rotta AT,Gunnarsson B,Fuhrman BP,et al.Comparison of lung protective ventilation strategies in a rabbit model of acute lung injury.Crit Care Med,2001,29:2176-2184.
10. Rüdiger M,Wissel H,Ochs M,et al.Perfluorocarbons are taken up by isolated type II pneumocytes and influence its lipid synthesis and secretion.Crit Care Med,2003,31:1190-1196.
11. Migliori C,Bottino R,Angeli A,Cattarelli D,Chirico G.Highfrequency Partial Liquid Ventilation in Two Infants.Journal of Peri2 Natology.J Perinatol,2004,24:118-120.
12. Rotta AT,Viana ME,Wiryawan B,et al.Combining lung-protective strategies in experimental acute lung injury: The impact of high-frequency partial liquid ventilation.Pediatr Crit Care Med,2006,7:562-570.
13. Doctor A,Price B,Bhargava N,et al.High-frequency oscillatory ventilation of the perfluorocarbon-filled lung: dose-response relationships in an animal model of acute lung injury.Crit Care Med,2001,29:847-854.
14. Göthberg S,Parker TA,Abman SH，et al.High-frequency oscillatory ventilation and partial liquid ventilation after acute lung injury in premature lambs with respiratory distress syndrome.Crit Care Med,2000,28:2450-2456.
15. Roemer WM,Gentzsch S,Andel H,et al.Pressure increase due to hydrostatic pressure of perfluorocarbon.Am J Respir Crit Care Med,2006,173:1046-1047.

Chinese Journal of Respiratory and Critical Care Medicine

Application of HFOV and PLV in ALI/ARDS

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